Provider Demographics
NPI:1033437603
Name:ALLIED DENTAL CARE
Entity Type:Organization
Organization Name:ALLIED DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-543-3533
Mailing Address - Street 1:21350 HAWTHORNE BLVD
Mailing Address - Street 2:# 156
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-5605
Mailing Address - Country:US
Mailing Address - Phone:310-543-3533
Mailing Address - Fax:310-543-0334
Practice Address - Street 1:21350 HAWTHORNE BLVD
Practice Address - Street 2:# 156
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5605
Practice Address - Country:US
Practice Address - Phone:310-543-3533
Practice Address - Fax:310-543-0334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA444561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty